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General NPI Number Information
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NPI Number | 1861462970
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Entity Type | Individual
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Provider Name | MELANIE MOONEY M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/23/2006
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Last Update Date | 06/04/2018
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Provider Practice Location Address
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Address Line | 423 S COLUMBIA AVE
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City | RINCON
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State | GA
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Zip | 31326
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Country | US
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Telephone | 912-826-8860
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Fax | 912-826-2813
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Provider Business Mailing Address
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Address Line | 602 E 72ND ST
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City | SAVANNAH
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State | GA
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Zip | 31405-4913
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Country | US
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Telephone | 912-819-7878
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Fax | 912-819-7850
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 39861
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License Number State | SC
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